My experience with burnout started very insidiously back in 2017. After a clinical day working face-to-face with patients and their relatives, I would spend the evening ruminating on negatives rather than focusing on how I was helping and supporting my patients. Things came to a head one day as I read an emailed patient complaint. I hadn’t been called out, and, in fact, the complaint was very general, but I internalized it and broke down in tears. I realized something was very wrong.
The pandemic has brought burnout to a head, but we were already seeing it in the health care system before 2020. In fact, 30% of doctors and residents surveyed in 2017 for the CMA National Physician Health Survey reported high levels of burnout. When we look at the 2021 survey, the picture is even more worrying: 53% now report high levels of burnout.
There are plenty of systemic and individual reasons for burnout, and the moral injury from growing distrust of medical professionals and scientists adds to these stressors. But if you are grappling with burnout, you don’t have to suffer in silence. Here’s what you should know.
What Is Burnout?
People struggling with burnout typically experience emotional exhaustion, a decrease in their feelings of personal accomplishment and depersonalization. It begins with subtle changes in behaviour and thoughts that become larger and larger over time — so much so that people may not realize they’re grappling with burnout until it’s having a serious impact on their work, their relationships with colleagues and more. Quite often, I’ll notice signs in my colleagues before they do.
What Does Burnout Look Like?
Burnout shows up in a lot of obvious and not-so-obvious ways. Physically, you might notice you often get clammy hands, an increased heart rate, headaches, stomach aches and intestinal issues — symptoms we may attribute to general anxiety.
Emotional regulation becomes increasingly challenging as burnout progresses. You may notice you’re snapping at others and are short or curt in conversation. You might be having a chat with a colleague and veer into venting about something unrelated. It’s as if the filters are gone. Outwardly, you may also be less animated and have a slumped posture that reflects your inner exhaustion.
Things you normally love and relish become a chore when you’re grappling with burnout. You might often think, “I wish I didn’t have to go into work” or “I don’t want to deal with these patients.” When I was experiencing burnout, I would start to get nervous the night before a clinical day because I was anticipating a demanding shift that I couldn’t properly cope with.
Burnout can also impact your performance. You may be unable to concentrate or feel you’re lacking in creativity. You might also avoid tasks and situations that can lead to further overwhelm. Checking email, for example, might fill you with dread if you’re anticipating requests that will add to your mental load.
How to Treat Burnout
Like most medical conditions, burnout is only going to get worse if you don’t address it. If you suspect you might be experiencing burnout, the first thing to do is to talk with someone you can trust and confide in, such as a family member, a colleague (preferably one you don’t work with directly), or your family doctor or therapist.
Next, lean on the resources available for physicians. Your medical association’s professional assistance program is an excellent place to turn. Their counsellors are trained to pick up on signs of burnout and can help direct you to appropriate resources and identify next steps.
If your burnout is severe, you may need to speak with your head of service or medical chief about adjusting your workload or taking time off to evaluate how to move forward in a healthier way. Taking time off won’t magically cure burnout, but it can give you time and space to think about what’s happening and how you can fix it.
There are lots of factors that could be contributing to your burnout, including lack of support for your personal interests and needs, systemic issues such as excessive workloads, inefficient processes and lack of autonomy, and poor leadership. The solutions will be unique to your situation, and they may require some outside-the-box thinking. Physicians often feel like we have to see patients all day, every day, but it’s okay if you opt to reduce your clinical hours.
Once you’re committed to making a positive change and the thought of doing so fills you with nervous excitement, coaching can help you find balance in your career and reconnect with your passions. Designing a career that supports your goals without compromising your wellness is the key to recovering from burnout and preventing it from happening again in the future.
You can start by looking at some of the resources offered on the Physician Wellness Page, of the College of Physicians and Surgeons of Ontario.